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AFTERMATH OF TRAUMA: HELPING KIDS COPE

In their roles as clinicians, scientists, teachers, and community members, mental health professionals can make a difference in the way our society responds to child trauma. Because child trauma exposure is so pervasive, it is important for all mental health professionals to have basic knowledge of its nature, effects, and appropriate initial responses.

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WHAT EVERY MENTAL HEALTH PROFESSIONAL SHOULD KNOW

Many children are exposed to traumatic life events.

About half of all American children experience a traumatic event (such as physical or sexual abuse, family or community violence, terrorism, disasters, traumatic loss), and many experience more than one such event. Some children live with chronic trauma, with no time for healing between events.

Almost all children experience acute distress immediately after exposure to a traumatic life event.

Children’s reactions will depend on their age and maturity. Children living with chronic trauma may become numb and appear unresponsive to further events. Most children will have some acute reactions but will return to their prior levels of functioning with time and with the support of family and trusted adults.

Parents and families are affected by trauma, and their responses affect children’s trauma reactions.

Family members may react very differently to the same traumatic experience, and their responses affect each other’s responses. In addition, children’s perceptions of trauma, their resources for coping, and their interactions with parents can vary by developmental level and culture.

Most children with trauma-related distress do not receive psychological treatment.

A substantial minority of trauma-exposed children develop psychological symptoms that warrant clinical attention, yet few receive services. Fewer still receive treatments that can be effective, such as cognitive-behavioral therapy.


HOW MENTAL HEALTH PROFESSIONALS CAN HELP

  • Identify trauma-exposed children and provide culturally appropriate information, support, and/or connections for follow-up and intervention.
  • Provide consultation to other professionals (in schools, health care settings, spiritual settings, and other service systems) who are working with trauma-exposed children and families.
  • Obtain special training and preparation, in order to participate in culturally responsive community disaster and emergency response.
  • If your practice includes children, obtain training in developmentally and culturally appropriate evidence-based therapies for child trauma to effectively treat those children who do not recover on their own.

BASIC TIPS FOR RESPONDING TO CHILD TRAUMA

DO Provide Education and Hope

  • Help the child and family to:
    • understand expected / normal trauma reactions
    • identify and use their existing coping skills
    • know when to ask for additional help
  • Convey an expectation of full recovery, with time and support

DO Match Care to Child Needs and Phase of Recovery

Immediately after trauma:

  • Attend first to basic needs – physical safety, shelter, medical needs, reuniting separated family members
  • Assess initial responses and arrange to follow-up over time
  • Support parent, family, and community efforts to:
    • provide a safe, developmentally-appropriate, culturally-responsive recovery environment for children
    • reduce ongoing exposure to stressors / secondary traumas
    • return to / establish normal roles and routines
    • activate support among kinship networks, spiritual systems, and the broader community

Any time after trauma:

  • Allow children to express feelings and reactions, if they want to
  • Help parents and other key adults in the child’s life to:
    • be aware of and manage their own reactions
    • listen and understand the child’s experiences and reactions
  • Assess factors that place children at higher risk for persistent adverse reactions
  • Assess current needs that may warrant clinical attention, such as:
    • severe or persistent distress, numbing, or impairment
    • reduced capacity of family / community to support child
    • red flags, including self-destructive or violent behaviors

When treatment is warranted:

  • Provide (or refer for) effective trauma-focused treatment
  • Respect child and family readiness for treatment
  • Keep doors open for future treatment

DO Understand Child, Family, and Cultural Perspectives

  • Listen carefully to child and family when planning interventions
  • Incorporate extended families and kinship networks
  • Ask about child/ family/community (cultural)/spiritual perspectives on trauma, reactions, and interventions
    • acknowledge and respect cultural healing practices
    • help families incorporate safe, culturally-appropriate practices

DO Take Care of Yourself

  • Engage in self-care for emotional, physical, and spiritual well-being
  • Consider limiting hours for treating families exposed to trauma
  • Watch for red flags of secondary stress or burnout (such as exhaustion, numbing, distancing, over-involvement with clients)
  • Know your limits. Enlist consultation or supervision as needed

BE AWARE OF POTENTIAL PITFALLS!

DON’T…

Assume that all children will respond to trauma the same way

Pathologize early distress or reactions

Convey the message that trauma exposure inevitably results in long-term psychological damage

Assume that all children exposed to trauma need formal psychological treatment, but recognize that some will

Force children or parents to tell their story, but listen carefully when they do

Create situations in which trauma-exposed children have little choice or control

Ignore your own stress from trauma-focused clinical work

 

 




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